Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2025-12-22-9

Project Information

Project IdentifiersProject ID: 995129
DEA: 07346204
EFIS: 0718000072
DIST-CO-RTE-PM07-LA,VEN-2,23,101-Var
Award Date04/10/2024
Closeout DateNot set
Work DescriptionUPGRADE AND INSTALL NEW TRANSPORTATION MANAGEMENT SYSTEM ELEMENTS.
Location DescriptionLOS ANGELES AND VENTURA COUNTIES AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 11/08/2024)

Sample Information

Sample Taken Date12/22/2025 Sample Unique Key9
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing12/24/2025
Sample typeQuality Assurance A brief description of the sampleThree 4"x8" Cylinders
The quantity of what the sample constitutes11.5 CY From where was the sample collectedFabricator
First name of sampler or witnessed byStephen Last name of sampler or witnessed byHaynes
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameStructureCast Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypePrecast Concrete The concrete mix design number8.5SKSCC-ES
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedtbd
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete Sample from Wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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Test File Attachments